Updated

How is it possible that a 67-year-old who is not overweight, watches his diet, had no significant cardiac risk factors when he was president of the United States and has exercised vigorously for years afterward suddenly needs a cardiac stent to open a blockage in an artery supplying his heart?

The answer is that if it can happen to him, it can happen to any of us. President Bush's experience is a wake-up call for all of us, especially those over the age of 50, to get checked regularly.

In President Bush's case, his senior spokesperson, Freddy Ford said to me "He had a stress test as part of his annual physical. During the stress test there were EKG changes, which prompted a CT angiogram that confirmed the blockage."

While stress tests aren't for everyone, I order them frequently in patients of President Bush's age who are smokers, have a family history of heart disease, have high blood pressure or high cholesterol or simply exercise vigorously the way the former president does.

There are over a million cardiac stents placed in patients in the U.S. every year, some for patients with minimal or no symptoms like President Bush, and some for patients on the verge of a heart attack.

What is a stent and how does it work? A catheter is inserted into the femoral artery in the groin and threaded up to the heart, into the coronary artery that is blocked. A tiny balloon is dilated to reopen the artery and a stent made of metal alloy is inserted and left there to keep the artery open.

Subsequently the patient is placed on anti-platelet drugs - aspirin and Plavix - as well as a cholesterol-lowering statin such as Lipitor or Crestor.

In an uncomplicated case such as President Bush's, the patient can generally go home the same day and return to work a few days later.

I expect President Bush's recovery to go well and I hope to be back riding mountain bikes with him again next year. He remains in great health, with an amazing, tiny piece of modern technology now helping to keep him that way.

If he can have a heart blockage, so can you. Go see your doctor for a physical if you haven't done so recently.